All AREBT members in clinical practice have a responsibility to promote the wellbeing of their clients. Under our Code of Conduct ‘you must behave with honesty and integrity’.
This means that when something goes wrong you must tell the client. You must also apologise. This is known as Duty of Candour and is a regulation of the Health and Social Care Act 2008 as well as a crucial part of care.
The Professional Duty of Candour states that all healthcare professionals have a duty to tell their service users when something has gone wrong. This means that every psychotherapist as a healthcare professional must be open and honest when something goes wrong with a client’s treatment or care.
You must let the person know that something has gone wrong and offer an apology. You should apologise for any harm caused, regardless of fault and be open and transparent about what has happened.
Apologising is an important part of Duty of Candour and is always the right thing to do. It is not an admission of liability. But it is important because:
- It allows steps to be taken to mend the relationship between psychotherapist and client
- The client receives a genuine apology for what has happened
- Steps can be taken to prevent the mistake from happening again
DUTY OF CANDOUR THROUGHOUT THE THERAPEUTIC RELATIONSHIP
As a psychotherapist you must be honest at the onset of therapy about the risks of therapy as well as the benefits, and should discuss these openly with your client so they can make an informed decision about their treatment. You should make them aware of your membership of AREBT within your initial contracting, and about their right to complain should they wish to.
As well as outlining risk at the beginning of therapy, this should also be reviewed throughout therapy. When introducing a change in approach or in level of risk this should always be fully discussed with the client. For example: you may have been initially working with a client with panic disorder, but then decide together with the client that a trauma focused approach would be more therapeutic. This needs to be discussed honestly with both risks and benefits outlined, so the client can make an informed decision.
Throughout therapy, we have a responsibility to make the client aware of any harm that may have occurred, whether they are aware of this or not. We must take action to limit any harm or to repair any harm. This could include for example, an incident where we have sent an email to a wrong email address, disclosing confidential information, or where our computer security has been compromised. Alternatively, we may become aware that we have said something unhelpful or inappropriate to a client and we need to be honest about our failings, and work to repair any harm.
If any harm occurs, we also need to offer an apology to the client. We must also take the issue to supervision and/or our employer. We need to then investigate what has happened to avoid it happening again. If the client wishes to complain we need to be open and honest about the complaints process and give them information about how to complain.
At the end of therapy, feedback must be sought from the client, so that any issues not disclosed earlier in the therapy, can be discussed honestly together and worked with.
This Professional Duty of Candour sits alongside our Code of Conduct which emphasises that ‘you must act in the best interests of your clients’ and ‘you must behave with honesty and integrity’.